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Nearsightedness: Should I Have Laser Surgery?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Laser
surgery for nearsightedness uses a laser to change the shape of the
cornea. The goal is to have you see clearly without
glasses or contact lenses or to be less dependent on them.

There
are two main types:

LASIK. LASIK makes a small flap in
the cornea and removes some of the tissue underneath.

Surface ablation
(PRK, LASEK,
and epi-LASIK). These three
surgeries are very similar. PRK removes the top layer of the cornea, and then
the cornea is reshaped. The layer grows back during the healing process. LASEK
and epi-LASIK loosen the top layer of the cornea and
push it out of the way. Then the cornea is reshaped and
the surface replaced. It takes more time to heal from PRK,
LASEK, and epi-LASIK than from LASIK, because the skin
cells need to grow back.

PRK, LASEK, epi-LASIK, and LASIK
have very similar long-term results. LASIK is the most common, but many people
have one of the other types done instead because of the
shape and condition of their eyes. LASEK may also be safer for people with
certain lifestyles, such as professional athletes, police officers, and
firefighters.

Other types of surgery for nearsightedness include
radial keratotomy,
corneal ring implants, and
intraocular lens implants. Talk to your doctor to see
if one of these is a better option for you.

Reduction in best corrected vision, which is the best
possible vision you can have using glasses or contact lenses.

Because laser surgery for nearsightedness has only been
available since the 1990s, experts still don't know if there are problems that may
occur many years later.

Serious problems that threaten vision are
rare. These include infection, sores on the cornea, and higher pressure inside
the eye, which can lead to
glaucoma.

Laser surgery for
nearsightedness is an elective procedure. This means that it's done for
personal, not medical, reasons. You must decide for yourself whether the
benefits of surgery outweigh the risks.

Before you
have surgery, an
ophthalmologist will examine you to see if you are a
candidate for the surgery. You may not be able to have the surgery if:

Your vision has not been stable for at least
a year.

You have certain problems in the cornea, such as
keratoconus, keratitis, corneal edema, or thinning of
the cornea.

You have irregular
astigmatism.

You have moderate or severe
dry eyes.

You have an uncontrolled
autoimmune or connective tissue
disease.

You are younger than 18.

You are pregnant or
breastfeeding. During pregnancy, women can have temporary changes in the way
their eyes focus.

You may not want this surgery if it could affect your
job. Some employers don't allow certain workers to have this surgery because of
the slight risk that it can cause permanent problems. Aircraft pilots, for
example, should check with their employers before deciding to have this
surgery.

Compare your options

Compare

What is usually involved?

What are the benefits?

What are the risks and side effects?

Have laser surgery
Have laser surgery

Your eye is numb, but you are
awake. The laser makes a permanent change to the shape of your cornea. The operation takes a few minutes for each eye. This doctor
visit, including paperwork, takes about 2 hours.

If you have LASIK,
you may have both eyes done at the same time. With PRK, eyes are usually done
on separate days.

Your vision may be blurry for a few days. You
can return to normal activities in a day or two.

You may wear an
eye patch or special contact lens for a few days.

You will have
little or no pain with LASIK, but you may have some pain with
PRK, LASEK, or epi-LASIK while the
skin cells heal. Your doctor will give you pain medicine if you need it.

Most people see better very
soon after surgery, without needing glasses or contacts (or needing them
only part of the time).

Because laser surgery for nearsightedness has only been available since the 1990s, experts still don't know if there are problems it can cause many years later.

Wear glasses or contact lenses Wear glasses or contact lenses

You rely on glasses or contacts for clear vision.

You avoid the
risks of surgery.

Contact lenses can cause eye problems, such as eye
infections and damage to the cornea.

It may bother you to wear
glasses all the time.

Personal stories about laser surgery for nearsightedness

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I've decided
to have LASIK surgery because I am tired of wearing glasses all the
time. I hate the way I look in glasses, and I've had lots of problems with
contact lenses. I've used glasses and contacts all my life, but in the past I
never really had a choice. I know there are a few risks involved with having
LASIK surgery, but for me the possibility of being able to see pretty well
without glasses or contacts is worth it.

Abby, age 38

I'm not
going to have surgery. It would be nice to be able to see better without my
glasses, but I'm not willing to risk the vision I have just so that I don't
have to wear my glasses anymore. My doctor is pretty sure I would need to wear
glasses some of the time anyway, even if I did have the surgery. I know people
who have been very pleased with the results, but I am too afraid that one of
those rare complications will happen to me.

Harry, age 44

I'm going to
have laser surgery so that I don't have to rely so heavily on my contact
lenses. For the most part, I haven't really minded wearing contacts. But I do
participate in a lot of sports and outdoor activities, and contacts can be a
real hassle when I'm out mountain-biking or playing soccer or doing anything
like that. Glasses aren't much better in those situations. Besides, it sure
would be nice to be able to wake up in the morning and see things clearly
without having to put in my contacts first.

Tomas, age 27

I'm not
going to have surgery right now. Some of the procedures are still fairly new,
and the surgery is very expensive. I would like to wait until there is more
information about the long-term results and until the doctors in my area become
more experienced with the newer procedures. I will probably reconsider having
surgery in a few years, but I'm not ready to have it at this
point.

Sally, age
28

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have laser surgery for nearsightedness

Reasons not to have laser surgery

I want to see well without having to wear glasses or contact lenses all the time.

I don't mind wearing glasses or contacts.

More important

Equally important

More important

The idea of having this surgery doesn't bother me.

The idea of having this surgery bothers me a lot.

More important

Equally important

More important

I think I'd do better at my job or my favorite activities if I didn't have to wear glasses or contacts.

Wearing glasses or contacts doesn't get in the way of my job or my favorite activities.

More important

Equally important

More important

I'm willing to accept the risk that surgery may only give me 20/40 vision.

I don't see the point of surgery if it can't give me 20/20 vision.

More important

Equally important

More important

For me, the benefits outweigh the possible risks of surgery.

I don't want to risk having problems from surgery.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having laser surgery for nearsightedness

NOT having surgery

Leaning toward

Undecided

Leaning toward

What else do you need to make your decision?

Check the facts

1.1, Do most people who have laser surgery for nearsightedness see better right away?

YesYou're right. Laser surgery is quick and often painless, and most people see better right away.

NoSorry, that's wrong. Laser surgery is quick and often painless, and most people see better right away.

I'm not sureIt may help to go back and read "Compare Your Options." Laser surgery is quick and often painless, and most people see better right away.

2.2, Is laser surgery risk-free?

YesSorry, this answer is wrong. This surgery can cause side effects. And although it is considered safe, it is new enough that we still don't know what long-term problems it might cause.

NoYou're right. This surgery can cause side effects. And although it is considered safe, it is new enough that we still don't know what long-term problems it might cause.

I'm not sureIt may help to go back and read "Get the Facts" under "What are the risks of surgery?" This surgery can cause side effects. And although it is considered safe, it is new enough that we still don't know what long-term problems it might cause.

3.3, Even if surgery gives you 20/20 vision, could you still need reading glasses when you get older?

TrueThat's true. This surgery doesn't affect the natural aging of your eyes. And if you're like many people, your eyes will naturally change shape as you grow older, and you'll need glasses for close vision.

FalseSorry, that's wrong. This surgery doesn't affect the natural aging of your eyes. And if you're like many people, your eyes will naturally change shape as you grow older, and you'll need glasses for close vision.

I'm not sureIt may help to go back and read "Get the Facts" under "Key points to remember." This surgery doesn't affect the natural aging of your eyes. Your eyes may naturally change shape as you grow older, and you'll need glasses for close vision.

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Nearsightedness: Should I Have Laser Surgery?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts

Compare your options

What matters most to you?

Where are you leaning now?

What else do you need to make your decision?

1. Get the Facts

Your options

Have surgery to correct your nearsightedness.
(You may still need to wear glasses or contact lenses part of the
time.)

Rely on glasses or contact lenses for clear
vision.

Key points to remember

Laser surgery
takes only a few minutes for each eye and helps you see better
quickly.

You may still need to wear glasses or contact lenses
sometimes, because the surgery does not always give
20/20 vision.

The surgery can cause side
effects. The most common one is cloudy vision, which usually goes away but may need further treatment.

Even if surgery
gives you 20/20 vision, it does not change the normal aging of the eye. So you
may still need reading glasses after age 40.

Laser surgery can cost
a lot. And most insurance policies won't pay for it.

FAQs

What is laser surgery for nearsightedness?

Laser
surgery for nearsightedness uses a laser to change the shape of the
cornea . The goal is to have you see clearly without
glasses or contact lenses or to be less dependent on them.

There
are two main types:

LASIK. LASIK makes a small flap in
the cornea and removes some of the tissue underneath.

Surface ablation
(PRK, LASEK,
and epi-LASIK). These three
surgeries are very similar. PRK removes the top layer of the cornea, and then
the cornea is reshaped. The layer grows back during the healing process. LASEK
and epi-LASIK loosen the top layer of the cornea and
push it out of the way. Then the cornea is reshaped and
the surface replaced. It takes more time to heal from PRK,
LASEK, and epi-LASIK than from LASIK, because the skin
cells need to grow back.

PRK, LASEK, epi-LASIK, and LASIK
have very similar long-term results. LASIK is the most common, but many people
have one of the other types done instead because of the
shape and condition of their eyes. LASEK may also be safer for people with
certain lifestyles, such as professional athletes, police officers, and
firefighters.

Other types of surgery for nearsightedness include
radial keratotomy,
corneal ring implants, and
intraocular lens implants. Talk to your doctor to see
if one of these is a better option for you.

How well does laser surgery work?

Laser surgery
gives most people 20/40 vision or better. Most doctors consider 20/40 vision a
successful result. If your vision is at least 20/40, you can drive a car
without glasses or contacts.

What are the risks of surgery?

Side
effects and problems from surgery may vary slightly depending on which type of
surgery you have. Most side effects either go away on their own or can be
treated and fixed.

Reduction in best corrected vision, which is the best
possible vision you can have using glasses or contact lenses.

Because laser surgery for nearsightedness has only been
available since the 1990s, experts still don't know if there are problems that may
occur many years later.

Serious problems that threaten vision are
rare. These include infection, sores on the cornea, and higher pressure inside
the eye, which can lead to
glaucoma.

Laser surgery for
nearsightedness is an elective procedure. This means that it's done for
personal, not medical, reasons. You must decide for yourself whether the
benefits of surgery outweigh the risks.

Are you a good candidate for surgery?

Before you
have surgery, an
ophthalmologist will examine you to see if you are a
candidate for the surgery. You may not be able to have the surgery if:

Your vision has not been stable for at least
a year.

You have certain problems in the cornea, such as
keratoconus, keratitis, corneal edema, or thinning of
the cornea.

You have irregular
astigmatism.

You have moderate or severe
dry eyes.

You have an uncontrolled
autoimmune or connective tissue
disease.

You are younger than 18.

You are pregnant or
breastfeeding. During pregnancy, women can have temporary changes in the way
their eyes focus.

You may not want this surgery if it could affect your
job. Some employers don't allow certain workers to have this surgery because of
the slight risk that it can cause permanent problems. Aircraft pilots, for
example, should check with their employers before deciding to have this
surgery.

2. Compare your options

Have laser surgery

Wear glasses or contact lenses

What is usually involved?

Your eye is numb, but you are
awake. The laser makes a permanent change to the shape of your cornea. The operation takes a few minutes for each eye. This doctor
visit, including paperwork, takes about 2 hours.

If you have LASIK,
you may have both eyes done at the same time. With PRK, eyes are usually done
on separate days.

Your vision may be blurry for a few days. You
can return to normal activities in a day or two.

You may wear an
eye patch or special contact lens for a few days.

You will have
little or no pain with LASIK, but you may have some pain with
PRK, LASEK, or epi-LASIK while the
skin cells heal. Your doctor will give you pain medicine if you need it.

You rely on glasses or contacts for clear vision.

What are the benefits?

Most people see better very
soon after surgery, without needing glasses or contacts (or needing them
only part of the time).

Because laser surgery for nearsightedness has only been available since the 1990s, experts still don't know if there are problems it can cause many years later.

Contact lenses can cause eye problems, such as eye
infections and damage to the cornea.

It may bother you to wear
glasses all the time.

Personal stories

Personal stories about laser surgery for nearsightedness

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I've decided to have LASIK surgery because I am tired of wearing glasses all the time. I hate the way I look in glasses, and I've had lots of problems with contact lenses. I've used glasses and contacts all my life, but in the past I never really had a choice. I know there are a few risks involved with having LASIK surgery, but for me the possibility of being able to see pretty well without glasses or contacts is worth it."

— Abby, age 38

"I'm not going to have surgery. It would be nice to be able to see better without my glasses, but I'm not willing to risk the vision I have just so that I don't have to wear my glasses anymore. My doctor is pretty sure I would need to wear glasses some of the time anyway, even if I did have the surgery. I know people who have been very pleased with the results, but I am too afraid that one of those rare complications will happen to me."

— Harry, age 44

"I'm going to have laser surgery so that I don't have to rely so heavily on my contact lenses. For the most part, I haven't really minded wearing contacts. But I do participate in a lot of sports and outdoor activities, and contacts can be a real hassle when I'm out mountain-biking or playing soccer or doing anything like that. Glasses aren't much better in those situations. Besides, it sure would be nice to be able to wake up in the morning and see things clearly without having to put in my contacts first."

— Tomas, age 27

"I'm not going to have surgery right now. Some of the procedures are still fairly new, and the surgery is very expensive. I would like to wait until there is more information about the long-term results and until the doctors in my area become more experienced with the newer procedures. I will probably reconsider having surgery in a few years, but I'm not ready to have it at this point."

— Sally, age
28

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have laser surgery for nearsightedness

Reasons not to have laser surgery

I want to see well without having to wear glasses or contact lenses all the time.

I don't mind wearing glasses or contacts.

More important

Equally important

More important

The idea of having this surgery doesn't bother me.

The idea of having this surgery bothers me a lot.

More important

Equally important

More important

I think I'd do better at my job or my favorite activities if I didn't have to wear glasses or contacts.

Wearing glasses or contacts doesn't get in the way of my job or my favorite activities.

More important

Equally important

More important

I'm willing to accept the risk that surgery may only give me 20/40 vision.

I don't see the point of surgery if it can't give me 20/20 vision.

More important

Equally important

More important

For me, the benefits outweigh the possible risks of surgery.

I don't want to risk having problems from surgery.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having laser surgery for nearsightedness

NOT having surgery

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
Do most people who have laser surgery for nearsightedness see better right away?

Yes

No

I'm not sure

You're right. Laser surgery is quick and often painless, and most people see better right away.

2.
Is laser surgery risk-free?

Yes

No

I'm not sure

You're right. This surgery can cause side effects. And although it is considered safe, it is new enough that we still don't know what long-term problems it might cause.

3.
Even if surgery gives you 20/20 vision, could you still need reading glasses when you get older?

True

False

I'm not sure

That's true. This surgery doesn't affect the natural aging of your eyes. And if you're like many people, your eyes will naturally change shape as you grow older, and you'll need glasses for close vision.

Decide what's next

1.
Do you understand the options available to you?

Yes

No

2.
Are you clear about which benefits and side effects matter most to you?

Yes

No

3.
Do you have enough support and advice from others to make a choice?

Yes

No

Certainty

1.
How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2.
Check what you need to do before you make this decision.

I'm ready to take action.

I want to discuss the options with others.

I want to learn more about my options.

Use the following space to list questions, concerns, and next steps.

Credits

By

Healthwise Staff

Primary Medical Reviewer

Kathleen Romito, MD - Family Medicine

Primary Medical Reviewer

Adam Husney, MD - Family Medicine

Specialist Medical Reviewer

Christopher J. Rudnisky, MD, MPH, FRCSC - Ophthalmology

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